Viewpoint: Killing NHS Direct – Something tells us this is very wrong

If so, the news can hardly be taken as any kind of encouraging sign that other New Labour high-profile ICT-health project, NPfIT, will survive much longer.

 

The Coalition has seemingly decided it likes a phone-based answer not NHS Direct's mixture of call centres directing callers be they from the Web or phone to banks of qualified nurses to help answer public health queries.

 

The new 111 service, currently on trial in the North East, looks set to sweep its now disfavoured predecessor away once it goes national.

 

The decision is clearly based on cost: 111 will use less nurses and so will be cheaper to run. But what about the investment, experience and user acceptance that NHS Direct has managed to build up in the 12 years it has been up and running, like the computerised medical support system costing £70m installed by 2001? Is that simply to be junked?

 

It looks as if that's a yes, which will strike some as genuinely a pity. As recently as June its current Chief Executive Nick Chapman was able to say its work with the flu pandemic had kept three million anxious visitors out of crowded GP practices last year among other achievements.

 

Admittedly, it took a while for NHS Direct to become accepted but by as early as 2005 it was hailed as one of the best regarded of all NHS services, with external evaluations by the National Audit Office and Commission for Health Improvement speaking very positively about the morale of the staff and the customer's satisfaction with the service. UNISON, the union and which represents most NHS staff, went so far that year as to hold it up as an example of “public services at their best”.

 

And though the Web side again took a while to take off, by mid-decade it was handling as many approaches from the public as the 0845 number - more than half a million telephone transactions a month. By as recently as 2006 a key Department of Health strategy document, Developing NHS Direct, says that it would eventually be the "single point of access" for all the NHS for out-of-hours care and its then Chief Executive was telling the press: “In two to three years we will be the portal to the entire NHS.” 

 

That didn't happen and there is certainly no shortage of sceptics – the BMA among them, suggesting in the summer that the service should be re-evaluated by the government as it (and the NPfIT )was of “questionable value”.

 

But NHS Direct had also built up a strong following among certain social groups - young mothers at home being one of its major constituencies. Many of us would have no shame admitting, surely, they'd called up for confidential advice to deal with worries or to get a quick bit of advice on weekends or even Christmas Day, when it is also fully manned?

 

At the same time, no-one claimed it was perfect, least of all itself. Chapman had led rationalisations, contract re-negotiations and closures of some call centres to make it a tighter ship, but still saw it as having a key role spearheading all future moves by the NHS into being able to deliver more and more services remotely.

 

Well – now we'll never know. Something feels wrong here. Something tells us that something useful is being sacrificed. Is this a feeling we're all going to have to get more and more used to over the next few years – from October on?